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Montana rates for HCPCS 21401

Closed treatment of fracture of orbit, except blowout; with manipulation

Facilitymedian $646 · 10th–90th $513–$9120%20%10th90th$646Professionalmedian $589 · 10th–90th $339–$1,2020%10%10th90th$589$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $537.03 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $501.19 / $812.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $812.83 / $912.01
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $812.83 / $912.01
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $549.54 / $870.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $537.03 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $616.60 / $933.25